Innovative Journal of Medical and Health Sciences

Chronic congenital nasolacrimal duct obstruction is common issue; & management of delayed chronic dacryocystitis is important problem especially in rural or tribal areas of India. Aim was to share our experience of external dacryocystorhinostomy (DCR) in paediatric chronic dacryocystitis. This retrospective study comprised a review of 57 eyes in 55 patients in the age group four to sixteen years. All underwent external dacryocystorhinostomy (in the period between 2000-2014) using single ‘U’ shaped anterior flap with minimum one yr of follow up. Study involved 24 male & 31female children; including two bilateral female cases, in 30 cases Rt. side was involved & in 27 Lt. side involved. Some cases had underwent probing in past (once/twice) but failed to relieve block were also included. Success was defined as absence of epiphora & discharge and in cooperative older children – patency after sac syringing .Results: Out of 57 eyes operated 54 cured with 94.73% success, only 3cases failed   with minimum 1 yr of follow up. Conclusion: external dacryocystorhinostomy in chronic congenital dacryocystitis is safe & effective; and strongly recommended in chronic neglected cases

Aims: The purpose of this study was to explore the effectiveness of a nursing capstone project course in enhancing nursing student creativity. Design: This study involved a pre–post-test design. Methods: Samples were tested through a questionnaire on factors influencing creativity during the first and final weeks of the course. The questionnaire included questions on nursing student characteristics, abilities, barriers, and motivations. This study was conducted from September 2014 to January 2015. A total of 300 nursing students were recruited, and 150 completed the pretest and posttest, indicating a 50% return rate. Of the 150 enrolled students, more than 90% had not participated in nursing project training or conferences or conducted nursing projects. Results: The nursing students exhibited significant differences in characteristics and abilities before and after the nursing capstone project course and showed enhanced positive characteristics and creative abilities by the end of the training course. However, the factors of barriers and motivations in creativity were not significantly different. The students also failed to enhance their creative motivations. Furthermore, the results of a multiple regression analysis revealed that before the nursing capstone project course, the students perceived the strongest predictors of their creativity to be abilities and barriers; by contrast, they perceived characteristics and motivations as the strongest predictors after the course. Conclusions: The nursing capstone project course affected the influencing factors of nursing student creativity. This study thus validates the effectiveness of the 18-week nursing capstone project course in enhancing the creativity of the nursing students, as indicated by the significantly increased creativity scores after the training course compared with those before the course.

Background：In Taiwan, the prevalence rate of gallstone disease (GD) is estimated to be 5%-10% among adults. Several reports have suggested that females and old age individuals have a higher prevalence rate of GD. In addition, hyperglycemia, dyslipidemia and obesity, which are common features of metabolic syndrome, are risk factors for GD. Few studies have examined the relationship between metabolic syndrome combined with fatty liver disease and gallstone disease. Purpose: This study aimed to investigate the relationship between metabolic syndrome combined with fatty liver disease and gallstone disease. Methods: This study applied cross-sectional data analysis. Participants received physical examination at a local hospital in Kaohsiung, Taiwan, from 2011 to 2014. Fatty liver disease and gallstone disease were diagnosed by a gastroenterologist with abdominal ultrasonography. The metabolic syndrome was defined according to the standards set by Health Promotion Administration, Ministry of Health and Welfare, in 2007. Physical examination and blood test results were employed to evaluate the prevalence rate and risk factors of gallstone disease.

Results: The results indicated that prevalence rate of GD was 5%. GD had a significantly higher prevalence among participants aged 40 years and older than those under 40 years old. GD prevalence rate was higher among participants with abnormalities associated with metabolic syndrome and its components than healthy participants. GD prevalence rate was significantly higher among participants with mild or moderate fatty liver combined with metabolic syndrome than those without the metabolic syndrome or with a different degree of fatty liver disease. Participants aged 40 years and older had a 2.88-fold higher risk of getting GD than those who were under 40 years old. The risk of GD increased 1.70-fold in participants with mild fatty liver disease combined with metabolic syndrome and 1.32-fold in participants with moderate fatty liver disease combined with metabolic syndrome. Conclusion: Prevalence and risk of GD is significantly higher in participants with metabolic syndrome. Awareness of GD prevalence rate and risk factors can facilitate effective GD prevention.

Telemedicine has the ability to bridge gaps and overcome barriers between the patient and the doctor. Physicians today are confronted with increasing demands to ensure and improve care of their patients. Previous research data suggests increasing and improving patient satisfaction above the expected rate.By summing up reviews, clinical trials and various researches in this field, this article critically reflects on the patient satisfaction with telemedicine, limitations and challenges in telemedicine.But one must be careful about the fact that given the complexity of improvement and changes in patient care, it is unrealistic to expect satisfaction with only one approach to solve health care problems.Even though data from patient satisfaction research suggests overwhelming response for this delivery modality, this review highlights some of the challenges and limitations in telemedicine related to methodology, data collection instruments, designs and approach. The field of telemedicine has developed tremendously in the last 50 years as technology and acceptance have improved. More effective examinations of patient satisfaction could play a role in moving telemedicine forward over the next 50 years. Understanding what the patient wants and the reason behind it can guide future projects of Telemedicine for a better outcome.